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Abstract
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Counseling patients on health risks and behaviors is a core competency for all clinicians. Patients are frequently presented with questionnaires assessing their use of seatbelts or the presence of stairs in their homes to help facilitate these discussions--encouraging patients to use appropriate safety seats for children or preventing falls for older adults. The same should be true for firearm safety, given that according to the Centers for Disease Control and Prevention, about 40 000 people die each year from firearm injuries, most of which are suicides.1 However, studies consistently show that physicians rarely ask about any aspect of firearm safety in health maintenance visits. Indeed, only about 20% of pediatricians ask more than 5% of their patients about gun ownership.2
In their Original Investigation in this issue of JAMA Health Forum, Dr Richards and colleagues3 present a cross-sectional study evaluating patients' self-reporting of firearm access on a questionnaire administered in a primary care or outpatient mental health setting. They found that most patients responded to the question in this format: more than 80% responded in a primary care setting, and more than 90% responded in a mental health care setting.
Physicians are legally allowed to counsel patients on gun safety in all states. The Patient Protection and Affordable Care Act prohibits required collection of information related to firearms but does not restrict firearm-related counseling between clinicians and patients,4 and after the Florida Firearm Owners' Privacy Act was overturned as a violation of physicians' First Amendment rights, no state statute regulates clinician-patient discussions on firearms.5,6
Asking this basic question is an important means by which clinicians can begin to understand firearm ownership among their patients. When clinicians were surveyed on what aspects of firearm safety education were most needed and would be most useful, they often requested specific language to use when talking to families.7 While we need a validated framework for how clinicians can approach these sensitive conversations, posing questions in a printed format is clearly an acceptable option. A simple questionnaire is an easy, efficient, and effective means of gathering important patient information. Especially for clinicians who may feel less confident asking these questions, this allows them to pose questions in a way that is respectful and nonjudgmental.
Inquiring about firearm access on a questionnaire opens the door to a potentially lifesaving discussion of firearm safety, but clinicians must step through it...
Language: en |